Antiepileptic Drugs (AEDs) Polypharmacy Could Lead to Buried Pharmacokinetic Interactions due to CYP450

Tolou-Ghamari, Zahra

doi:10.2174/1872312811206030008

Cited by 12 publications

(17 citation statements)

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“…In conclusion, experienced pharmacotherapy in relation to drugs with narrow therapeutic windows and in terms of recommendations based on detailed benefitrisk assessment requires thorough understanding and the establishment of well-balanced pharmacokinetic parameters in the Iranian population (31)(32)(33)(34)(35)(36). Finally, the cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase complex 1 (VKORC1) genotypes have been confirmed to be associated with warfarin dose requirements.…”

Section: Discussionmentioning

confidence: 99%

Review of Warfarin; A Cytochrome P450 Metabolizing Drug, in Clinical Practice

Tolou-Ghamari

Mazdak

2016

Jentashapir J Health Res

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Context: For the prevention and management of thromboembolic complications, warfarin is the most extensively recommended anticoagulant. It is categorized as a drug with a narrow therapeutic window. Therefore, warfarin prescription requires special attention related to therapeutic drug monitoring.Evidence Acquisition: By categorizing the clinical implications of warfarin, this manuscript aims to provide a comprehensive (albeit somewhat brief) conclusion associated with its pharmacotherapy. The key words relevant to the topic were searched. Consequently, articles relevant to the pharmacotherapeutic management of warfarin were selected and reviewed in their entirety. Results:To obtain a reasonable level of stability between the required antithrombotic treatment and the risk of bleeding, an analysis of the literature revealed that the prothrombin time in terms of the international normalized ratio (INR) was found for each individual. The best model for stable warfarin dosage prediction was found to be based on multiple linear regression. Genotypeguided procedures were established to: 1, improve the time in the therapeutic range; 2, reduce time to the first therapeutic INR; and 3, reduce the time for the stable doses. Vitamin K epoxide reductase is an enzyme with an important role in vitamin K metabolism, and warfarin is metabolized in hepatocytes via a monooxygenase, cytochrome P450 2C9. In patients carrying 2C9*1/*2 and 2C9*2/*2 or 2C9*1/*3 alleles, the dose is recommended to be reduced by 18% -40% and 21% -49%, respectively. Conclusions:Race, age, body surface area, chronic kidney disease, CYP2C9*3 level, and VKORC1 variants could affect the dose of warfarin. To administer the proper doses of warfarin, patients and physicians might achieve the best results with the pharmacologist proficient anticoagulation database and recommended continuation program. Owing to its' unpredictability, caution must be taken when prescribing warfarin. More advanced warfarin pharmacotherapy studies are recommended based on a linear regression model specifically in the Iranian population.

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Section: Discussionmentioning

confidence: 99%

Review of Warfarin; A Cytochrome P450 Metabolizing Drug, in Clinical Practice

Tolou-Ghamari

Mazdak

2016

Jentashapir J Health Res

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“…Within this population spiritual believing could improve heart rate and the ability of immune system to fight against the attack in such conditions. Indeed, God is with the patient with those who have believed, seek help through patience and entreaty [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Spirituality believing by patients could lead to better care.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding to organ transplantation, the legendary and symbolic uses of the different parts of body in texts and paintings continue a fairly unknown topic. Previous publications reported that organ donation could be described as the manifestation of the love of our neighbor [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. A recent study performed in 5360 deceased confirmed that in order to prevent worse outcome in critically ill patients admitted to hospitals, quality of care need to be upgrading [20].…”

Section: Introductionmentioning

confidence: 99%

Spirituality Believing in End Stage Diseases Such as; Genito-Urinary Cancers, Multiple Sclerosis, Recipients of Liver, Kidney or Heart Transplantations

Tolou-Ghamari¹

2017

Foc Sci

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Background: Attention to spirituality could be a good way of communication, phenomenon and definitive evidence in order to commemoration of God compassionate. In such events praise of God compassionate could be a guide to recognize secret alternatives to healing approach connected to dissimilar phases of diseases. By considering in heart and compassionate performing, medical staffs are stimulated to follow therapy, management and advocates to save life and to relief others. Objectives: The aim of this review was to bring the importance of attention to spirituality believing of patients by commemoration of God in events that pharmacotherapy or surgical attempts could not able to lead toward satisfied outcome. Methods: 3830 patients with diagnosed neurologic disorders, 743 kidney recipients and 100 liver recipients were studied. The key words relevant to topic of study were searched through DOAJ, Google Scholar, Pubmed, and Web of Science.

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“…According to the authors' previous clinical experiences associated with efficacy, safety and side-effects of drugs used in clinical practice (11)(12)(13)(14)(15), United States national library of medicine (PubMed, NLM) were searched. The …”

Section: Evidence Acquisitionmentioning

confidence: 99%

A Review on Clinical Pharmacokinetics of Tamsulosin in Patients with Benign Prostatic Hyperplasia

Ghamari

Mazdak

2016

Jundishapur J Chronic Dis Care

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Context: Benign prostatic hyperplasia (BPH) that disturbs aged males is described as the abundant, chronic progressive disorder usually associated with lower urinary tract symptoms. The alpha 1A-adrenergic receptor antagonist, tamsulosin (Flomax®/Omnic®), seems to be an appropriate management from the view point of urological surgeons. The current review aimed to evaluate the clinical pharmacological properties of tamsulosin in prostate disorders. Evidence Acquisition: United States national library of medicine (PubMed, NLM) were searched from April 1991 to March 2016. The Mesh terms were: tamsulosin, tamsulosin pharmacokinetics in urology, tamsulosin in BPH and clinical pharmacokinetics of tamsulosin in BPH. Published clinical trials and review articles applicable to pharmacotherapy of tamsulosin in BPH were reviewed. Results: In patients with mild international prostate symptom score (< 8) to moderate symptoms of BPH, initial treatment with an alpha 1-adrenergic antagonist monotherapy were useful. With a half-life of 9 -13 hours, the oral bioavailability of drug was reported 100%. The drug is metabolized by liver. Excretion through renal was reported 76%. Initial dose of drug was 0.4 mg/day and the maximum dose was reported 0.8 mg/day. The drug could cause dizziness, sever drowsiness and problems in thinking, driving and many other complications. Other serious adverse reactions could be mentioned as hives, rash, itching, and difficulty in breathing, swelling of face, lips, tongue and throat. Tamsulosin therapy should be stopped in patients who experience hypotension. Conclusions: To treat BPH therapeutically, it is necessary to stabilize severities of the patient's symptoms with potential side effects of the treatment. Tamsulosin blocks alpha 1-receptors in smooth muscles both in the bladder neck and prostate, which leads to relaxation and subsequently less resistance to urinary flow. By advancement of tamsulosin, pharmacotherapy strategies could provide more appropriate guideline treatments; therefore, in Isfahan, Iran, innovative medical treatment for BPH was suggested based on both pharmacological and surgical clinical trials.

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Antiepileptic Drugs (AEDs) Polypharmacy Could Lead to Buried Pharmacokinetic Interactions due to CYP450

Cited by 12 publications

References 0 publications

Review of Warfarin; A Cytochrome P450 Metabolizing Drug, in Clinical Practice

Review of Warfarin; A Cytochrome P450 Metabolizing Drug, in Clinical Practice

Spirituality Believing in End Stage Diseases Such as; Genito-Urinary Cancers, Multiple Sclerosis, Recipients of Liver, Kidney or Heart Transplantations

A Review on Clinical Pharmacokinetics of Tamsulosin in Patients with Benign Prostatic Hyperplasia

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